Aims/hypothesis The aim of this study was to analyse patterns of continuous glucose monitoring (CGM) data for associations with large for gestational age (LGA) infants and an adverse neonatal composite outcome (NCO) in pregnancies in women with type 1 diabetes. Methods This was an observational cohort study of 186 pregnant women with type 1 diabetes in Sweden. The interstitial glucose readings from 92 real-time (rt) CGM and 94 intermittently viewed (i) CGM devices were used to calculate mean glucose, SD, CV%, time spent in target range (3.5–7.8 mmol/l), mean amplitude of glucose excursions and also high and low blood glucose indices (HBGI and LBGI, respectively). Electronic records provided information on maternal demographics and neonatal outcomes. Associations between CGM indices and neonatal outcomes were analysed by stepwise logistic regression analysis adjusted for confounders. Results The number of infants born LGA was similar in rtCGM and iCGM users (52% vs 53%). In the combined group, elevated mean glucose levels in the second and the third trimester were significantly associated with LGA (OR 1.53, 95% CI 1.12, 2.08, and OR 1.57, 95% CI 1.12, 2.19, respectively). Furthermore, a high percentage of time in target in the second and the third trimester was associated with lower risk of LGA (OR 0.96, 95% CI 0.94, 0.99 and OR 0.97, 95% CI 0.95, 1.00, respectively). The same associations were found for mean glucose and for time in target and the risk of NCO in all trimesters. SD was significantly associated with LGA in the second trimester and with NCO in the third trimester. Glucose patterns did not differ between rtCGM and iCGM users except that rtCGM users had lower LBGI and spent less time below target. Conclusions/interpretation Higher mean glucose levels, higher SD and less time in target range were associated with increased risk of LGA and NCO. Despite the use of CGM throughout pregnancy, the day-to-day glucose control was not optimal and the incidence of LGA remained high. Electronic supplementary material The online version of this article (10.1007/s00125-019-4850-0) contains peer-reviewed but unedited supplementary material, which is available to authorised users.

Abstract. Wilhelmsen L, Johansson S, Rosengren A, Wallin I, Dotevall A, Lappas G (Sahlgrenska University Hospital at Östra, Göteborg University; and Astra Hässle AB, Mölndal; Sweden). Risk factors for cardiovascular disease during the period 1985᎐1995 in Göteborg, Sweden. The GOT-MONICA Project. J Intern Med 1997; 242: 199᎐211.Aims. To report levels of cardiovascular risk factors in 1985, 1990 and 1995 in three population samples in Göteborg, Sweden, and to compare with previous population risk factor levels. Population. The study was performed within the framework of the WHO MONICA Project which compares risk factor levels as well as the incidence of coronary heart disease and stroke in 38 populations. Methods. Three random samples of men and women aged 25᎐34, 35᎐44, 45᎐54 and 55᎐64 comprising 152᎐218 subjects in each age group who responded to the invitation for screening procedures which included questionnaires, physical and laboratory investigations in 1985, 1990 and 1995. Results. More men than women had smoked, except for those aged 35᎐44 where there was no difference between men and women. The proportion of men who had smoked decreased strongly between the first and third investigations (P Ͻ 0.0001), particularly amongst the younger age-groups, with a similar tendency amongst women. In the 25᎐44-years age group there was a tendency towards more women than men to be smokers in 1995. Snuff was used by 27% and 19% of men aged 25᎐34 and 35᎐44 years, respectively, in 1995. Up to 5% of women used snuff; higher in the younger age groups. More young men than women reported regular physical activity during leisure time with a tendency towards an increase from 1985 to 1995. The proportion of men reporting psychological stress varied little over the study period, but women aged 25᎐34 reported increased stress from 1985 to 1995. Body weight increased whereas height remained stable and consequently body mass index increased in men and women (P ϭ 0.0001). Similarly, waist:hip ratio (measured in 1990 and 1995 only) also increased (P ϭ 0.0001). Mean systolic and diastolic blood pressure increased with age and there was also a small increase between 1985 and 1995. Systolic blood pressure increased by a mean of 1.24 mmHg per 5-year period independent of sex and age (P ϭ 0.0001). Antihypertensive treatment increased with age, but was stable between 1985 and 1995. Serum total and LDL cholesterol concentrations increased with age, and there was a nonsignificant tendency also to higher HDL cholesterol concentrations at older ages. Serum total cholesterol concentration declined between 1985 and 1995, and HDL cholesterol declined significantly between 1985 and 1995 in all age groups for men and women only when all age groups were analysed together. Similar to total cholesterol, levels of LDL cholesterol declined between 1985 and 1995 for all ages. Serum triglyceride levels increased for men and women between 1985 and 1995.

Abstract. Rosengren A, Dotevall A, Wilhelmsen L, Thelle D, Johansson S (Sahlgrenska University Hospital/Ö stra, Göteborg; Göteborg University, Göteborg; AstraZeneca Research and Development, Mölndal; Sweden). Coffee and incidence of diabetes in Swedish women: a prospective 18-year follow-up study. J Intern Med 2004; 255: 89-95.Objectives. To examine the long-term incidence of diabetes in relation to coffee consumption in Swedish women. Design. Prospective longitudinal cohort study. Setting. City of Göteborg, Sweden. Subjects. A random population sample of 1361 women, aged 39-65 years, without prior diabetes or cardiovascular disease took part in a screening study in 1979-1981 with questionnaires, physical examination and blood sampling. Main outcome measures. The development of diabetes until 1999 was identified by questionnaires in a second screening and the Swedish hospital discharge register.Results. Altogether, there were 74 new cases of diabetes. The risk of developing diabetes was 475 per 100 000 person-years in women who consumed two cups of coffee or less per day, 271 in women who consumed three to four cups per day, 202 with a consumption of five to six cups per day, and 267 in drinkers of seven cups or more per day. Associated hazard ratios, after adjustment for age, smoking, low physical activity, education and body mass index were 0.55 (0.32-0.95), 0.39 (0.20-0.77) and 0.48 (0.22-1.06) for daily consumption of three to four, five to six and seven cups or more, respectively, with a consumption of less than two per day as reference. Additional adjustment for serum cholesterol and triglycerides attenuated the relation between coffee and diabetes slightly, indicating a possible mediating effect on the effect of coffee by serum lipids. Conclusions. The findings of the present study support the hypothesis that coffee consumption protects from the development of diabetes in women.

Background Job control and work environment are related to risk of coronary heart disease (CHO), but there is limited understanding of the independent risks associated with these factors.Objective To investigate the association between psychosocial work characteristics and biological risk factors for both sexes for a random population sample in Goteborq, Sweden.Design A cross-sectional study.Methods We used an age-stratified random sample of men and women aged 25-64 years comprising 1200 men and 1412 women, from which 746 men and 872 women responded to the invitation for screening, which included questionnaires and physical/laboratory investigations in 1995.Results Women had lower job control than did men (p= 0.0000 1); job demands were equal and social support at work slightly higher among women (P=0.04). Job control was positively related to education and social group. Smoking women had low job control and high job demands. Women with high grades of psychological stress had low job control and low social support at work (P = 0.00 1 and P = 0.0 1). For both sexes job demands were high (P= 0.0001) among those who reported high psychological stress. Men with high job control and high social support at work were more physically active during leisure time. Subjects with job strain had low social support (P= 0.0 1).Job-stress factors were not related to biological coronary risk factors.Conclusions Women had lower job control than did men. Job control was positively related to education, social class and physical activity. Psychosocial factors were not related to biological coronary risk factors. J Cardiovasc Risk 6:379-385

Among middle-aged Swedish women even very slightly elevated s-TG resulted in a considerably enhanced risk of developing diabetes, which was independent of age, BMI, blood pressure and physical activity.

In women with ACS, diabetes is associated with higher risk of presenting with ST-elevation ACS, developing Q-wave MI, and of in-hospital mortality, whereas in men with ACS diabetes is not significantly associated with increased risk of either. These findings suggest a differential effect of diabetes on the pathophysiology of ACS based on the patient's sex.

Background Even though coronary mortality in middle and old age is decreasing, social gradients may be increasing; but they need not necessarily be the same for men and women. In order to develop efficient preventive strategies more knowledge of the current distributions of risk factors both for men and for women is needed. Objective To investigate and to compare the socio-economic gradients for coronary risk factors of men and women. Design A cross-sectional study. Methods We studied 686 men and 825 women aged 25–64 years from a random population sample. Socio-economic status (SES) was classified according to the occupation-based Swedish Socio-economic Index. Results For women, high SES was associated with lower levels of total and low-density lipoprotein cholesterol, lower serum levels of triglycerides, higher levels of high-density lipoprotein cholesterol and lower blood pressure. For men, no relation between occupational status and levels of lipids and blood pressure was found. Obesity was associated with low SES both for men and for women. Socioeconomic differences in smoking habits were more pronounced for women than they were for men. The proportion of post-menopausal women was higher among the unskilled workers, despite there being no difference in age. Optimal risk factor status (non-smoker, total cholesterol level < 5 mmol/l, blood pressure < 140/90 mmHg without treatment and body mass index < 25 kg/m2) was unusual both among men and among women, but 34% of the higher officials among the women had optimal risk factor status, compared with 10% of the unskilled workers. Corresponding values for the men were 16 and 9% (P for interaction 0.09). The relation between low SES and level of low-density lipoprotein cholesterol was independent of smoking, post-menopausal state, use of oestrogen and waist: hip ratio (P = 0.04) and so was the relation between systolic blood pressure and low SES (P = 0.0003). Conclusions In Sweden, low SES exerts a stronger adverse influence on cardiovascular risk factors of women than it does on those of men.

Abstract. Dotevall A, Rosengren A, Lappas G,